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Custom Triflange Acetabular Implants: Average 10-Year Follow-Up.

John B Meding1, Lindsey K Meding1

  • 1The Center for Hip and Knee Surgery, Mooresville, Indiana.

The Journal of Arthroplasty
|March 23, 2023
PubMed
Summary

Custom triflange acetabular implants show promising 6-13 year survivorship for severe bone defects. These implants achieve good radiographic stability and functional scores, despite challenges with infection and instability.

Keywords:
Paprosky 3A and 3Bacetabular bone losspelvic discontinuityrevision total hip arthroplastytriflange acetabular implants

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Engineering

Background:

  • Acetabular reconstruction with substantial bone deficiency (Paprosky 3A/3B) presents limited options.
  • Custom triflange acetabular implants offer a solution for complex cases.
  • Limited data exists on the long-term survivorship of these implants beyond 3-5 years.

Purpose of the Study:

  • To evaluate the clinical outcomes and survivorship of custom triflange acetabular implants.
  • To report 6 to 13-year results in patients with Paprosky 3A/3B acetabular defects.

Main Methods:

  • Retrospective review of 42 revision total hip arthroplasties (41 patients) using custom triflange acetabular components.
  • All cases involved Paprosky 3A or 3B acetabular defects.
  • Average follow-up of 10 years (range, 6-13 years) for 40 implants, with clinical assessment via Harris Hip Scores.

Main Results:

  • Mean Harris Hip Score of 74 at final follow-up.
  • Implant survivorship was 95% radiographically stable at final follow-up.
  • Complications included 5% deep infection (2.5% implant removal) and 7.5% dislocations.

Conclusions:

  • Custom triflange acetabular implants demonstrate comparable outcomes to other methods for extensive acetabular bone loss.
  • Instability and infection are key concerns in these complex reconstructions.
  • The implants show acceptable long-term results for challenging acetabular defects.